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Block 2 Pharm > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

1
Q

Insulin Preparations: Rapid Acting

A
  • Lispro
  • Aspart
  • Glulisine
    ONSET: 5-10mins
    PEAK: 1-2hrs
    DURATION: 3-4hrs
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2
Q

Insulin Preparation: Intermediate

A
  • NPH
  • Lente
    ONSET: 2hrs
    PEAK: 4hrs
    DURATION: 16hrs
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3
Q

Insulin Preparation: Long Acting

A
  • Glargine
  • Detemir
  • Ultralente
    ONSET: 60-90min
    PEAK: PEAKLESS
    Duration: >24hrs
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4
Q

Insulin Bolus Distribution

A
  1. 3-0.5 U/kg
    - 2/3 in AM (2/3 as NPH, 1/3 as Regular)
    - 1/3 in PM (1/2 as NPH, 1/2 as Regular)
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5
Q

Hypoglycemia S/S S/Sx [Autonomic]

A 
*BGL: 40-70*
Sympathetic
- Tremor
- Anxiety
- Paresthesia
- Palpitations
- Sweating
Parasympathetic
- Nausea
- Hunger

TX: Sugar

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6
Q

Factitious Hyperinsulinemia

A

Self ingested Insulin

  • Hypoglycemia
  • Antibodies
  • Suppressed plasma C Peptide
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7
Q

Glipizide

A

Helps your Pancreas make insulin

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8
Q

Hypoglycemia Tx

A

Glucagon
D50
Diazoxide

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9
Q

Diazoxide

A

MOA: INC K+ efflux, preventing Insulin secretion
TOXICITY: Hyperglycemia, Ketoacidosis

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10
Q

High Glucose Response

A

INC Insulin

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11
Q

Low Glucose Response

A

INC Glucagon, Cortisol, GH, Epi

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12
Q

Glucagon Clinical Uses

A

Severe Hypoglycemia
Endocrine Dx
Beta Blocker OD Antidote
Radiology of the Bowel (Relaxes intestines)

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13
Q

DKA Tx

A 
IV Insulin (Regular)
IV Fluids
D50
Correct Electrolytes
K+
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14
Q

Chronic Complications of DM

A

Retinopathy (leads to blindness)
Nephropathy
Neuropathy (Peripheral - Pain, Numbness and Tingling; Autonomic - Impotence and Gastropareisis)
Amputations

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15
Q

Peripheral Neuropathy Tx

A

GABA-Pentin

Pregabalon

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16
Q

Hypoglycemia S/S S/Sx [Neuroglycopenic]

A 
BGL Less than 40 mg/dL
- Dizziness
- Weakness
- Difficulty Concentrating
- Blurry Vision
- Feeling of warmth
- Drowsiness
- LOC
TX: D50 and Glucagon
17
Q

Insulin Preparation: Short Acting

A
  • SC/IV Regular Insulin
    ONSET: Less than 30min
    PEAK: 2-4hrs
    DURATION: 5-7hrs
18
Q

Goals for Therapy

A

FBS: 70-100
PPBS: Less than 140
HbA1C: Less than 7%

19
Q

Insulinoma

A
  • Benign Insulin Tumor
  • Serum Insulin 8 mg/dL w/ BGL less than 40 mg/dL
  • Inappropriate high insulin deposit w/ low BGL
  • 1mL Insulin = 1mL C Peptide
    RX: Surgery
20
Q

Difference b/w Hyperosmolar Coma and DKA

A

No Ketoacidosis

High BUN

21
Q

Tissues that Don’t Need Insulin

A 
Brain
RBCs
Intestines
Cornea
Kidney
Liver
22
Q

Insulin Secretagogues and Fxn

A

Sulfonylureas
Glitinides
- INC insulin production from Beta Cells
- SE - Hypoglycemia

23
Q

Insulin Sensitizers and Fxn

A

Biguanides - Weight Loss
Thiazolidinediones - Weight Gain
- Don’t Act on Beta Cells
- NO Hypoglycemia

24
Q

Alpha Glucosidase Inhibitors and Fxn

A

Acarbose
Miglitol
- Slow down digestion of starch so that glucose gets reabsorbed lower
- SE - GI Discomfort

25
GLP1 Analoges and Fxn
Exenatide Liraglutide - Bind to Glucagon Receptors - INC Insulin Production
26
DDP4 Inhibitors and Fxn
Sitagliptin Saxagliptin - INC GLP1 - Reduces Glucagon - INC Insulin
27
Amylin Analog and Fxn
Pramlintide - Slow gastric emptying - Suppress Glucagon * *Good for Type I AND II DM**
28
SGLT Inhibitors and Fxn
Canagliflozin - Block reuptake of Glucose in Renal Tubules (Glucouria) - SE - Weight Loss and Hypoglycemia
29
Sulfonylureas
``` First Gen - Tolbutamide (Short Acting), Chlorpropramide (Long Acting - SIADH) Second Gen (Lower dose, Less Side Effects) - Glipizide (Short), Glyburide (Long) ``` MOA: Block K+ Channels, INC Insulin SE: Hypoglycemia, Weight Gain CI: Renal & Hepatic Insufficiency Drug Interations: INC effect in - Cimetidine, Insulin, Salicylates, Sulfonamides
30
Biguanides
Metformin MOA: DEC PP Glucose, INC Tissue Sensitivity to glucose - NO HYPOGLYCEMIA OR WEIGHT GAIN SE: GI Distress and Lactic Acidosis (w/ renal impairment and heart problems) CI: Alcoholism, Renal hepatic Disease, Chronic cardiopulmonary dysfxn
31
Thiazolidinediones
Pioglitazone Rosiglitazone MOA: Bind PPAR-y, INC Insulin Receptors, DEC Hepatogluconeogenesis SE: Hypoglycemia (less than sulfonylureas), Weight Gain, Edema, Risk of Heart failure (Ros more than Pio) CI: Heart Pts
32
Acarbose
MOA: Delayed carb digestionAlpha-Glucosidase Inhibitor - Inhibits Glucose absorption, DEC PPBS - NO HYPOGLYCEMIA OR WEIGHT GAIN SE: GI Discomfort (Flatulence, Diarrhea, Hepatotoxicity
33
Pramlintide
MOA: Delays gastric emptying (Acts on RANK), "fullness feeling", Suppress glucagon release SE: Hypoglycemia
34
Exenatide and Liraglutide
MOA: Augments glucose dependent insulin secretion (Can be used in combo w/ Sulfonylureas or metformin) SE: Nausea, Hypoglycemia, Necrotizing and Hemorrhagic Pancreatitis
35
Sita/saxagliptin
MOA: Inhibit DDP4 to INC GLP1 - INC Glucose mediated insulin secretion and DEC glucagon levels SE: Hypoglycemia, URTIs, Joint Pain, acute pancreatitis
36
Canagliflozin
MOA: Block SGLT2 transporter - DEC Glucose Reabsorption SE: Hypotension/Dehydration CI: Severe Renal impairment

Block 2 Pharm (8 decks)

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